Only 48 hours had passed since the bilateral commission between the Government and the Govern, and the first discrepancy between both Executives jumped on account of the possible transfer of the Resident Internal Physicians (MIR) to Catalonia.

It all started when the Minister of Health, Carolina Darias, he corrected a statement on Monday by the minister spokesperson, Isabel rodriguez. After presiding this Wednesday the Interterritorial Council of the National Health System (CISNS), in his appearance before the media, Darias assured that “it is not on the agenda” of the Government to transfer the competence of the MIR.

Furthermore, the Minister of Health wanted to “make it very clear” that the Government of Pedro Sanchez it will continue “with the same system that we have until now.” “If anything, continue to expand the coverage of places, always hand in hand with the autonomous communities and the Human Resources Commission,” he added.

Minutes later, the Minister of the Presidency of the Generalitat, Laura Vilagrà, he responded to the minister on Twitter assuring that this matter “is on the agenda.” Vilagrà maintains that in the bilateral commission “the Catalan and Spanish governments agreed to create a working group to discuss this transfer and others.”

In reality, the mess comes from afar, because the first to put on the table the request to transfer the MIR -de facto, all the Specialized Health Training (FSE), which also includes nurses, pharmacists, chemists, etc.-, was the former Minister of Health, Alba Vergés, early 2020.

In the last Interterritorial Council in person before the pandemic, in February, the counselor announced the intention of having the “sole” management of this training area. At that appointment, the counselor reported that she had already begun to develop a “professional dialogue forum” about her own needs as professionals and MIR training.

But Darias even corrects what was agreed by the PSOE with United We Can in its document for the Coalition Government signed in December 2019. In it, Pedro Sánchez and Pablo Iglesias They ratified an agreement by which they committed to transfer the management of specialized health training. It is true that, at that time, sources from Moncloa assured EL ESPAÑOL that the transfer was almost impossible because “neither the Generalitat wants it, nor will the Government give it up.”

Neither does the Catalan Ministry of Health He has never specified what his MIR project would be like, in the event that he obtained that transfer. Sources of the counseling Consulted yesterday by EL ESPAÑOL, they stated that “today” that of the MIRs is “one of the points from which we could have results sooner”. Although, they pointed out, “we have nothing concrete.”

Total rejection

But, beyond who proposed what and the dialectical mess between the government ministers themselves and between the Government and the Generalitat, the truth is that the proposal has fallen like a jug of cold water among those affected.

Professional associations, representatives of future residents and unions reject the proposal that, according to EL ESPAÑOL has learned, has not even gone through the National Council of Specialties. Although this body, belonging to the Ministry of Health, has a voice in the offer of places and the modification of training programs, it has not been consulted about a possible transfer of the MIR.

But, what do the Catalan authorities want this transfer for? The main fear of unions and future resident doctors consulted by EL ESPAÑOL is clear: to enforce the language requirement. In other words, that the competence management of a future Catalan MIR is used to demand Catalan from professionals. And it is that, as the unions assure, “there are not many more competences that they can take”.

The places that are offered, the training programs and even the contracts are managed by the autonomous communities to which the health workers are referred.

The sources consulted assure that there is still no project on the table and that “not even” the Catalan Ministry of Health he knows “what they want to do with the management of the training of the MIRs”.

It is assumed that what is intended is to comply with what the Statute of Catalonia says on this point. And specifically, in the Statute it is claimed that the community, in a shared way with the Government of Spain, has competences in “specialized health training, which includes accreditation and evaluation of centers; planning the supply of places; the participation in the preparation of the calls and the management of the training programs of the specialties and specific training areas and the issuance of diplomas in specific training areas “.

Sources familiar with the process assure that most of these points already correspond to a shared management between Health and the regional government (number of places, accreditation of centers, training programs) therefore, the only thing that the Catalan government would have to manage would be matters related to the language.

Until now, Spanish is the only language used in the MIR exam, both for applicants of Spanish nationality and for foreigners who, in addition, must prove a level C1 or C2 of Spanish.

In fact, a few months ago Republican Left He denounced that the limitation of accepting only degrees in Spanish to take the MIR test had given many problems to applicants from Catalan centers.

Sistema MIR

It must be remembered that the Specialized Health Training (ESF) It exists in Spain since 1976 and depends directly on the Ministry of Health. In a decentralized health system like the Spanish one, the department of Darias maintains the organization of this training process for future specialists doctors (MIR), nurses (EIR), pharmacists (FIR), among many others. It is one of the few centralized health managements next to the National Transplant Organization (ONT).

From Health (with its corresponding bodies such as the Interterritorial Council of the National Health System, the Human Resources Commission or the National Council of Specialties) Aspects such as the number of affiliated centers, the teaching units, the specialties taught or the places are decided. All this goes through a previous offer by the CCAA, but it is Health that has the last word.

Thus, Health is also the one that centralizes the access system to the squares. From the department of Carolina Darias, a single exam is prepared for the entire country (according to the health specialty: doctors, nurses, pharmacists, chemists, etc) and, according to the final classification of each applicant, you can choose places offered.

The score obtained from the exam is weighted together with the academic record to enter a kind of opposition contest that is held once a year.

In this way, skills such as language remain in the background and have no place. Something that does happen in some public job offers (PEO). In the PEOs, it is the sole competence of the regional government to establish the indicators and, there, there are some legal loopholes by which executives such as the Balearic have demanded the language when accessing the square.

Barcelona, ​​MIR destination

At the moment, Barcelona is the third preferred city for the MIRs and the EIRs, after Madrid and Valencia. In addition to having a large number of places in many different specialties, the Catalan capital is home to some of the most important hospital centers in the country.

Every year, Barcelona is one of the cities where places are previously sold out, although, as the MIRs of Catalonia have on occasion denounced, this attraction is decreasing. But this is not a question of the level of training or the offer, but of hours and salaries.

Right now, Catalonia equates the conditions of the MIRs to those of its officials, therefore, in addition to working longer hours, they earn less than in other autonomous communities. According to the group, the working day of doctors resident in Catalonia is 37.5 hours a week instead of 35, as in other autonomies.


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